Posturometric modification after the application of an orthodontic Herbst type appliance in patients with Juvenile Idiopathic Arthritis

Aim: The aim of this study is to evidence the role of the posturography platform in the registration of the computerized dynamic analysis which could be useful to evaluate the effective treatment capacity of an orthodontic appliance Herbst type and its effects on the balance of the patient. Methods: A telescopic Herbst type orthodontic appliance was applied on a patient with Juvenile Idiopathic Arthritis (JIA) showing a right side deviation of the jaw in opening mouth. This device is a Fixed functional device, with telescopic mechanism that allows the protrusion dislocation of the jaw, manufactured with laser welding and roll bands of 0.07mm thickness, with a cantilever settled on the band from the first molar to the canine. This device applies unilateral force to resolve the deviation of the jaw in this patient. Before and immediately after the application of the Herbst appliance, we evaluated the variation of the posturography using Lizard Ultimateâ posturography platform by the registration of the computerized dynamic analysis. In both cases the test was conducted in open eyes state. Results: After the application of the Herbst orthodontic appliance, we immediately obtained a rebalancing of the postural position, an improvement in the postural loads and repositioning of the center of the gravity in a balanced position. Particularly, the load on the right foot is changed from 45 kg (before the application of the Herbst appliance) to 43,9 kg after the application of the appliance. while the load on the right heel changed from 17kg to 14,7kg. and the total torsion of the patient changes from 4,27 ° to 2,82°. Conclusion :The postural monitoring of the orthodontic case falls within the essential tests of orthodontics. After the execution of the basic exams that are necessary for the therapy that is personalized for each patient, other physiologic dynamics must be monitored which are related to each other. In conclusion, in this specific case we noticed that the application of an Herbst type orthodontic appliance has improved the balance, the weight loads and the position of the patient’s gravity center.